FEASIBILITY ON SHORT HYDRATION REGIMEN OF INTERMEDIATE- TO HIGH-DOSE CISPLATIN-BASED CHEMOTHERAPY FOR OUTPATIENT TREATMENT

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Abstract

Background

Cisplatin (CDDP) is an antineoplastic drug used in the treatment of many solid cancers. While toxic effects include gastrotoxicity, ototoxicity, myelosuppression, and allergic reaction, the main dose-limiting side-effect is nephrotoxicity. To reduce nephrotoxicity with CDDP, prolonged-time hydration for days has been commonly used. Recently, the feasibility of CDDP short hydration regimen that consists of 2000 ml of fluids with diuretics was developed, and the procedure made chemotherapies including CDDP possible in outpatient clinics. In our institution, we started to use and promote the CDDP short hydration regimen from September 2010 supported by the oncology team.

Purpose

To elucidate the feasibility of the short hydration regimen with CDDP administration.

Methods

Sixty-five patients treated with CDDP (>40 mg/m2) short hydration regimen (208 procedures), during the period from September 2010 to December 2011, were retrospectively reviewed.

Results

The patients consisted of 59 patients with lung cancer and 6 with other cancers, with the median age of 64 years. Median dosage and course of CDDP was 75 mg/m2 and 4, respectively. Total number of short hydration prescription was 208 (outpatient setting: 111, hospitalizing: 97). Thirteen patients had completed the CDDP chemotherapy (median 4courses) in outpatient setting. Adverse effects included nephrotoxicity (grade1 (G1):14, G2:1, G3: 1), and heart failure (G3:1). The regimen was not completed in three patients because of adverse effects. The incidence of nephrotoxicity in patients with lung cancer treated with high dose CDDP (>75mg/m2) was lower than with conventional hydration protocol.

Conclusion

CDDP administration with the short hydration protocol was feasible and convenient in outpatient clinics.

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